History of Public Health

Polio vaccination
Polio vaccination in India


The World Health Organization (WHO) described health in 1948, as “A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.

  • Physical determinants – It includes factors like geography (e.g. high land versus low land), the environment, and industrial development (e.g. pollution).
  • Socio-cultural determinants – It includes factors like beliefs, traditions, and social customs in society. It also involves the economy, politics, and religion in the community.
  • Community organization – It includes the community size, arrangement, and distribution of resources.
  • Behavioural determinants – it includes factors like individual behavior and lifestyle affecting the health of an individual and the community.

Historical markers in the development of Public Health:

400 BC: Greece – Personal hygiene, fitness, nutrition, sanitation, occupational health. Hippocrates – clinical and epidemic observation and environmental health.

500 BC to AD 500: Rome – Focused on aqueducts, sanitation, baths, public baths, municipal planning, military and occupational health.

500 – 1000: Europe – Destruction of Roman society and the rise of Christianity; sickness as punishment for sin, prayer, fasting, and faith as therapy; poor nutrition and hygiene pandemics; anti- science.

1300: Pandemics – bubonic plague, diphtheria, typhoid, measles, anthrax, tuberculosis, trachoma, scabies and other until the eighteenth century.

1348 – 1350: Black Death – origins in Asia, spread by armies of Genghis Khan, world pandemic kills 60 million in fourteenth century.

1796: Edward Jenner – Produced first vaccination against smallpox.

1854: John Snow – waterborne cholera in London: Broad Street Pump.

1862: Louis Pasteur publishes findings on microbial causes of diseases.

1876: Robert Koch discovers anthrax bacillus.

1883: Louis Pasteur vaccinates against anthrax.

1884: Diphtheria, staphylococcus, streptococcus, and tetanus organisms identified.

1923: Health organization of League of Nations

1928: Alexander Fleming discovers penicillin.

1929 – 1936: The Great Depression – widespread economic collapse, unemployment, and poverty in industrialized countries.

1946: World Health Organization founded.

1977: WHO adopts Health for all by the year 2000.

1978: Alma-ata Conference on Primary Health Care.

1979: WHO declares eradication of smallpox achieved.

1981: First recognition of AIDS.

1998: WHO Health for All in the Twenty-first century adopted.

Definition of Public Health

According to A.C. Winslow, “Public health is an art and science of preventing disease, prolonging life and promoting physical health and efficiency through organized community efforts for the sanitation of the environment,  the control of community infections, the education of the individual in principles of personal hygiene, the organization  of medical and nursing services for the early diagnosis and preventive treatment of disease and the development of the social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health”

  • Key Terms in the Definition of Public Health

Health Promotion:

  • Health promotion is a key element in public health and is applicable in the community, clinics or hospitals, and in all other service settings.
  • It helps in increasing the involvement and control of the individual and also the community in their own health.
  • It acts to improve health and social welfare and to reduce determinants of diseases and risk factors that adversely affect the health, and well-being of an individual or society, in a cost-effective way.


  • Prevention is defined as the goals of medicine that are to preserve, promote, and restore health when it is impaired, and also to minimize suffering and distress.
  • There are three levels of prevention:
  1. Primary prevention:
  • It refers to those activities that are undertaken to prevent the disease and injury from occurring.
  • It works with both the individual and the community.
  1. Secondary prevention:
  • It refers to the early diagnosis and management so as to prevent complications from disease.
  • It includes steps to isolate cases and treat or immunize contacts to prevent further epidemic outbreaks.
  1. Tertiary prevention:
  • It includes the activities which are particularly directed at the host and the environment in order to promote rehabilitation, restoration, and maintenance of maximum function after the disease and its complications have stabilized.


  • It is the process of restoring a person’s social identity by repossession of his/her normal roles and functions in society.
  • It involves the restoration and also maintenance of a patient’s social, psychological, physical, vocational, and emotional abilities.

Main goals of Public Health

  • Prevention of diseases, disorders, and injuries.
  • Promotion of good health, by encouraging healthy behaviors.
  • Ensuring the provision of quality, affordable medical services.
  • Protection of people from disease outbreaks, environmental hazards.
  • Responding to minimize the impact of adverse health conditions during times of emergencies.

Public Health practices are focused on three broad areas. (CDC)

  1. Assessment: Monitoring the health situation of communities.
  2. Policy development
  3. Assurance

Core Disciplines of Public health

There are many fields that come under public health. Some major disciplinary are given below:

  • Demography
  • Epidemiology
  • Biostatistics
  • Environmental health
  • Nutrition
  • Physical and Health Education


  1. World Health Organization
  2. Centers for Disease Control and Prevention